AMALIA KHUSNA

DIGESTIVE PHYSIOLOGY

1. Explain why the stomach is strongly related to brain/mind!

There is part of our body’s nervous system located in our gut. It’s called the
enteric nervous system. The enteric nervous system’s network of nerves, neurons and
neurotransmitters extends along the entire digestive tract – from the esophagus, through
the stomach and intestines, and down to the anus.
Because the enteric nervous system relies on the same type of neurons and
neurotransmitters that are found in the central nervous system, some medical experts
call it our “second brain.” The “second brain” in our gut, in communication with the
brain in our head, plays a key role in certain diseases in our bodies and in our overall
mental health.
ENS main role is controlling digestion, from swallowing to the release of
enzymes that break down food to the control of blood flow that helps with nutrient
absorption to elimination. The ENS may trigger big emotional shifts experienced by
people coping with irritable bowel syndrome (IBS) and functional bowel problems such
as constipation, diarrhea, bloating, pain and stomach upset. Gastrointestinal (GI)
problems can create anxiety and stress. We also know that anxiety and stress can make
GI problems worse. Irritation in the gastrointestinal system may send signals to the
central nervous system (CNS) that trigger mood changes.
The brain has a direct effect on the stomach and intestines. For example, the
very thought of eating can release the stomach's juices before food gets there. This
connection goes both ways. A troubled intestine can send signals to the brain, just as a
troubled brain can send signals to the gut. Therefore, a person's stomach or intestinal
distress can be the cause or the product of anxiety, stress, or depression. That's because
the brain and the gastrointestinal (GI) system are intimately connected.
When a person feels danger, the “fight or flight” response of the central nervous
system is triggered. At the same time, the enteric nervous system’s response is to slow
down or stop digestion. This is done so that more of the body’s energy can be diverted
to the situation causing the threat so stomach is related to brain.

2. Explain briefly the physiological digestive mechanism of sugar, protein, and fat!
a. Sugar
1) Karbohidrat dari makanan (polisakarida) diubah menjadi disakarida melalui
bantuan enzim amilase dari kelenjar liur dan pankreas
2) Disakarida yang berupa laktosa, maltosa, dan sukrosa kemudian diubah menjadi
monosakarida oleh masing masing enzim yang berkaitan (laktase, maltase, dan
sukrase) di brush border enzim pada usus halus
3) Monosakarida berupa galaktosa glukosa, dan fruktosa kemudian diserap oleh vili
usus halus dan memasuki peredara darah lalu dibawa menuju hati melalui vena
porta hepatitis.

b. Protein
 1) Protein diubah menjadi asam amino dan beberapa fragmen peptida kecil oleh pepsin
lambung dan enzim proteolitik pankreas (tripsin, kimotripsin, dan
karboksipeptidase)
2) Peptida kecil kemudian diubah menjadi asam amino oleh bantuan enzim
aminopeptidase di brush border
3) Asam amino diserap ke dalam sel epitel usus halus melalui mekanisme transpor
aktif sekunder yang bergantung pada Na+ dan energi. Asam amino meninggalkan
sel epitel melalui difusi terfasilitasi dan memasuki peredaran darah kapiler lalu
dibawa menuju hati melalui vena porta hepatis.

c. Fat
1) Garam empedu akan melakukan emulsifikasi (mengubah globulus lemak besar)
menjadi butiran halus. Emulsi ini bertujuan untuk meningkatkan luas permukaan
yang tersedia untuk dicerna oleh lipase pankreas
2) Garam empedu akan membentuk selaput bermuatan negatif pada permukaan
butiran lemak sehingga emulsi lemak tidak akan menggumpal kembali
3) Lipase pankreas akan memecah lemak menjadi monogliserida dan asam lemak
bebeas
4) Garam empedu dan konstituen empedu lainnya akan membentuk misel. Misel
memiliki sifat hidrofilik pada bagian luarnya & hidrofobik pada bagian dalamnya.
Substanso yang tak bias larut dalam air seperti lemak akan masuk ke dalam inti
misel dan dibawa oleh misel menuju ke permukaan absorptif usus halus
5) Ketika mendekati epitel usus yang absorptif, monogliserida dan asam lemak akan
meninggalkan misel dengan cara berdifusi masuk ke dalam sel
6) Dalam sel, monogliserida dan asam lemak bebas diubah menjadi trigliserida.
Trigliserida-trigliserida menyatu dan dibungkus oleh lapisan lipoprotein dalam
retikulum endoplasma untuk membentuk kilomikron yang larut air. Kilomikron
kemudian dikeluarkan melalui membran basal sel lalu masuk ke pembuluh limfe.

3. Explain why protein diet is powerful to normalize cholesterol level!

Higher-protein diets are associated with lower BMI and waist circumference and higher
HDL cholesterol compared to protein intakes at RDA levels. Our data suggest that
Americans who consume dietary protein between 1.0 and 1.5 g/kg BW potentially have a
lower risk of developing cardiometabolic disease.